Langenbeck's Archives of Surgery

, Volume 384, Issue 3, pp 250–258

Immunological consequences of laparoscopic surgery, speculations on the cause and clinical implications

Authors

  • C. Sietses
    • Department of Surgery, Faculty of Medicine and Academic Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands (Tel.: +31-20-4444781, Fax: +31-20-4444511)
  • R. H. J. Beelen
    • Department of Cell Biology and Immunology, Faculty of Medicine and Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands
  • S. Meijer
    • Department of Surgery, Faculty of Medicine and Academic Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands (Tel.: +31-20-4444781, Fax: +31-20-4444511)
  • M. A. Cuesta
    • Department of Surgery, Faculty of Medicine and Academic Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands (Tel.: +31-20-4444781, Fax: +31-20-4444511)
ORIGINAL ARTICLE

DOI: 10.1007/s004230050200

Cite this article as:
Sietses, C., Beelen, R., Meijer, S. et al. Langenbeck's Arch Surg (1999) 384: 250. doi:10.1007/s004230050200

Abstract

Background: Immune suppression is an established consequence of surgical stress and trauma. Postoperative changes in the systemic immune system are proportional to the degree of surgical trauma and subsequent immune suppression may be implicated in the development of infectious complications and tumor metastasis formation. Laparoscopic surgery reduces the magnitude of the operative trauma and is thought to preserve postoperative immunological defenses. Methods: Relevant literature concerning postoperative immune functions and laparoscopic surgery was reviewed and clinical implications are discussed. Results: The influence of laparoscopic surgery on the postoperative systemic immune response is significantly less after laparoscopic cholecystectomy than with the conventional approach. Few immunological data are available concerning more advanced laparoscopic procedures. Various animal model studies of postoperative septic complications and tumor growth show that the postoperative preservation of the systemic immune response after laparoscopic surgery can have enormous clinical advantages. Conclusion: Laparoscopic surgery preserves the postoperative immunological defenses. In the future, this may imply a lower number of infections, less local recurrence and even fewer distant metastases. Prospective randomized studies are necessary to see whether these suspected advantages can be demonstrated in clinical practice.

Key words Laparoscopic surgerySystemic immune response

Copyright information

© Springer-Verlag Berlin Heidelberg 1999